HomeMy WebLinkAboutBuilding Permit Application 05/15/2017 14:01 7724626448 SLC CODE COMP PAGE 02/03
05/7.5/2017 12:60 772461203 STEVE SMITH AC PAGE 02/03
ALL APPLICAB INF MUST BE COMPLi' FOR APjPUCAMW TO BE A=FMI)
Date. �r/7 Permit Number,-
Building
umber.Building permit A►ppikation MAY 1.5 201r
Planning and Develapm&ntServjws
Building and Code Regulatlan Divisian. i PF_R M I TTi NI G
29DOVirginia Avenue,FottPlermFL,34982 5t. Lucia c
Phone:17721462-1533 Fix:(772)4621578 q-din erdal Residential
PERMIT APPLICATION FOR: Ta Select>mni dioPbox,click arrow at the end of line
Address•_�„��Q�
Legal Dettription: e D
ProperlyTax f0#:
Lot No.,_�
Site Plan Name: Block No.
Project Name:
Setbacks Front Back._. Right Side: Left side:
Additional Work o be perfoftedUnder OCR IV a appy;
HVAC Gas Tank II� Pip�nB _Shutters Wir:dows/Doors
�El9ctric i.�l Plumbing �5pr9nkl rs Generator ORoof Roofp r
Total Sq.Ft of Construction- `1T .Ft.of First Floor;-
cast AfCongtructiort: ;Utilities;Sewer ZSeptic Building Height:
{Name Name:slevasm>ih
Address: Company:Steve Smith Air C:ansii fling
City: Address: 8001!Eden Road
Zip Code: zm:�� Fax: ,. Fort pi" .PL
Phone No,_ fr Zip Code.34flfi1 Fax:772 469�?A86
E-Mail-, Phone No.772 481-1426
MI In fee sirttple Title Holder an next page{if dlffwr nt E-Mail:stavesmilh=4 aol.com
from the Owner Bated abovgl State or County Ucense.CAC18VW 4129071
It value of construction Is$ZOO or mons,.a RECDRDEa NoeiCe of Cema+enceru>Qrtt is segWtrd.
05/15/2017 14:01 7724626448 SLC CODE COMP PAGE 03/03
05/15/2817 12:50 772461203E, STEVE SMITH AC
PAGE 03103
DESIGNE:P/ENGINEER: Ni Appli le MORTGAGE COMPANY: Not Applicable
NAme. : — — Name.
Address:: Address:
City: ., I .State, City-, te,
ztp- hone.-
P Zip:
Phone.
FEE SIMPLE TITLE HOLDER: 9 Not Applicable SONDING COMPANY:
I -�—Nvt Applicable
Name,. - Name:
Address:: Address:
City,
Zip: Phone; Zip: Phone:
OWNER/,CONTRACTOR AFFIDVIT-Application is hereby made to obtain a permit to do the work and Installation as Indicated.
I certify th,6tno work or bisullaucir;has r-ornmenced priorto the issuance of a oermit.
St.Lc!eg0=maKIno,repr;sentation that is granting a permit will aut oriza the ennit holder to build the
, &ctstructure
whichIs init Ictwit anyap Icable Hoe owners AssWotion rules,bvPl covenants that may ct prehiwt such
structure.Tease consult with your Home Owners Association and review 1 CIr any restrictlansih PIZ
which may apply.
In comsideiatior of the granting of this requested permit,I do hereby agree that I will,in ag respects pWarm the Work
In accordance with the approved plans,-the Florida SWIding Codes and St Lucie County Amandmants.
The following building permit applications are exempt from undfiraoing a full concurrency review:room additions,
accessary structures,swimming pools,imces,walls,signs,screen rooms and accessory urea to another non-residential use
I
WARNIN TKA DWNER:Your fallum to Record a Notice cif Commencement may result In Your Paying twice for
improvehients to your property.A Notice of Commencement must be recorded and posted an the jobsite
before the first inspection.If you intend to obtain financing,con5tift with lender or an attomey,beApre
commeticin amork or recordin-e our Notice of Commencement
51griatu 04nar/Agew Lessee Signature of ebntractoTAlcense Holder
STATE OF FLORIDA STATE OF FLOR1_0A
COUNTY.OF—NLI.- COUNTVOF L-
lite�Minstrumem was acknowlefte
dbefore me The fo
,ring instrument Was acknowledged befbire me
this this day of 20=bV
ge,
lName of person acknowledging) (Name of person acknowledging)
(Signaturo of WFiry Piifbru�State of Florida) (SlPaWti—0f NotaFV Pu-bllc Stoe of Florida)
Personally,Known OR Produced Ideritificr4on Personally xnown_OR Produced Idertfific2tion
Type of IdelnMcartion Produced 70e of Identification
Carnmiss'llon No. Riff SAB Commisdan No-EE iZJNLa
_25. (seal�w DAVI$
�-ARY PITBLIo NOTARYPUBW
STATEOFFLORIDA &MR611ATE-017 FLORVA
. md
Revise4 07/1512014 Cori
REVIEWS FRONT 70NING SUPERVISOR PLANS VEGETATION T SEATURTLE MANGROVE
COUNTER REVIEW RWEW REVIEW REVIEW REVIEW REVIEW
-TA—TE ;
RECEIVED
tDATE
COMPLETED